Ingabe unesifo esibangelwa amagciwane? Ake sifunde ngokuhlolwa kwe-Gram Stain.

Ungase uzibuze ukuthi iyini le "Gram Stain". Ungase ukhathazeke kancane lapho udokotela ekucela ukuthi wenze lokhu kuhlolwa. Kodwa ungakhathazeki. Lokhu kuhlolwa okulula kakhulu, futhi okubaluleke kakhulu okwenziwa njalo. Namuhla, sizoxoxa ngakho ngokuningiliziwe, kalula kakhulu.

Kuyini ukuhlolwa kwe-Gram Stain?

Kalula nje, i-Gram stain ukuhlolwa kwelebhu okwenziwa ukuze kubonakale ukuthi kukhona yini ukutheleleka endaweni ethile emzimbeni wakho, futhi uma kunjalo, ukuthi kubangelwa yini amagciwane. Cabanga ukuthi unesilonda esibuhlungu noma isilonda esibonakala siqhuma. Khona-ke udokotela angase asole ukuthi sihlobene namagciwane. Ngaleso sikhathi, lokhu kuhlolwa kunganikeza umbono ngokushesha ngakho.

Lokhu kuhilela ukuthatha isampula yomchamo wakho, ubomvu esilondeni, noma into efanayo bese uyibheka ngaphansi kwesibonakhulu. Lokhu kunikeza umbono ocacile wokuthi akhona yini amabhaktheriya nokuthi, uma ekhona, abukeka kanjani. Lokhu kusiza udokotela ukuthi anqume ukuthi yimiphi imithi okufanele akunike yona nokuthi yiziphi ezinye izivivinyo okufanele uzenze.

Isingeniso esifushane ngamabhaktheriya

Amabhaktheriya ayisilwane esincane kakhulu, esineseli elilodwa. Atholakala emizimbeni yethu, esikhumbeni sethu, futhi cishe yonke indawo endaweni ezungezile. Ezinye izinhlobo zamabhaktheriya azisilimazi, futhi ezinye ziyasisiza. Kodwa kunezinhlobo ezithile zamabhaktheriya abangela izifo nezifo ezahlukahlukene. Ukuhlolwa kwe-Gram stain kuyasiza kakhulu ekuboneni amabhaktheriya anjalo ayingozi.

Kulesi sivivinyo, amabhaktheriya ashintsha imibala ehlukene ngokusekelwe kumakhemikhali kanye nezakhiwo zomzimba zezindonga zamaseli awo. Ngakho-ke, ahlukaniswa ngokuthi "angu-gram-positive" noma "angu-gram-negative". Kodwa into eyodwa okufanele uyikhumbule ukuthi akuwona wonke amabhaktheriya athintwa yile ndlela ye-Gram stain. Futhi, kunezikhathi lapho lesi sivivinyo sodwa singakwazi ukusho ngqo ukuthi siyini lesi sifo. Kodwa-ke, sinikeza umbono omkhulu ngohlobo lwamabhaktheriya, okuwusizo olukhulu ekuqaleni ukwelashwa.

I-Gram stain iyindlela ebaluleke kakhulu yokufaka amabala ebilokhu isetshenziswa ku-microbiology amakhulu eminyaka. Yaqala ukwethulwa ngo-1882 yisazi samabhaktheriya saseDenmark uHans Christian Gram. Waqala ukuyisebenzisa ukuhlonza izinto eziphilayo ezibangela i-pneumonia.

Ayini amabhaktheriya e-Gram-positive kanye ne-Gram-negative?

Manje ake sibone ukuthi iyini yonke le nto ene-Gram-positive ne-Gram-negative. Lokhu kuhlukaniswa kusekelwe endleleni amabhaktheriya asabela ngayo ngodayi ofakwe kusampula ngesikhathi sokuhlolwa kwe-Gram stain. Amanye amabhaktheriya aphenduka umbala onsomi-oluhlaza okwesibhakabhaka, kanti amanye aphenduka umbala obomvu opinki.

Lapha , elithi "positive" alisho "okuhle", futhi alisho "okubi".I-Negative ayisho ukuthi "kubi" noma "akukho bhaktheriya." Kumane nje kuyisigaba esisekelwe endleleni amabhaktheriya asabela ngayo kudayi. Ngezinye izikhathi, amabhaktheriya abizwa nangokuthi "i-gram-variable." Lokhu kusho ukuthi awadaki ngendlela efanayo, futhi angabonakala exubile epinki nephuzi.

Amagciwane ane-gram-positive

Izindonga zamaseli zama-bacteria ane-Gram-positive zakhiwe ngezingqimba ezijiyile zento ebizwa ngokuthi i-peptidoglycan . I-Peptidoglycan iyisakhi esiyinhloko samaseli ama-bacteria amaningi. Yakha cishe u-90% wamaseli ama-bacteria ane-Gram-positive. Yingakho zibonakala ziluhlaza okwesibhakabhaka kuya konsomi e-Gram stain.

Ezinye izinhlobo zamagciwane ane-Gram-positive yilezi:

• `Izinhlobo ze-Staphylococcus`
• `Izinhlobo ze-Streptococcus`
• `Izinhlobo zeCorynebacterium`
• `Izinhlobo ze-Clostridium`
• `Izinhlobo ze-Listeria`

Amagciwane angenayo i-gram

Amabhaktheriya angenayo i-gram anesendlalelo esincane se-peptidoglycan (cishe u-10% wodonga lweseli) ezindongeni zamaseli awo. Anephesenti eliphezulu lama-lipid (okungukuthi ama-fatty acid) ezindongeni zamaseli awo. Yingakho ebonakala ebomvu kuya kopinki e-Gram stain.

Ezinye izinhlobo zamagciwane angenayo i-Gram yilezi:

• `I-Neisseria gonorrhoeae kanye ne-Neisseria meningitides`
• `Izinhlobo zeMoraxella`
• `I-Escherichia coli (E. coli)`
• `Izinhlobo ze-Pseudomonas`
• `Izinhlobo ze-Proteus`
• `Izinhlobo ze-Klebsiella`

Uyini umehluko phakathi kwe-Gram stain kanye ne-bacterial culture?

Uma udokotela wakho esola ukuthi unesifo samagciwane, uvame uku-oda kokubili ukuhlolwa kwe-Gram stain kanye nokuhlolwa kwe-bacterial culture. Kodwa-ke, ulwazi olutholwe kulezi zivivinyo ezimbili luhlukile.

Cabanga ngale ndlela, ibala eliyi-gram lifana nephoyisa eliya endaweni yobugebengu bese libhala ngokushesha incazelo emfushane yabasolwa (njengokuphakama, umbala, nezingubo). Lokhu kukunikeza umbono osheshayo wokuthi ubani okhona lapho.

Ukukhuliswa kwamagciwane kuyinqubo lapho amabhaktheriya asesampula ekhuliswa endaweni ekhethekile yezakhamzimba elabhorethri bese ekhonjwa ngegama. Lokhu kungathatha izinsuku eziningana, njengoba amanye amabhaktheriya ekhula kancane. Kodwa futhi kusiza ukuhlonza amabhaktheriya aqondile kanye nokwelashwa okufanele kwawo.

Ngakho-ke, umphumela osheshayo ovela ku-Gram stainNgisho noma itholakale, ivame ukukutshela uhlobo lwamagciwane kuphela. Kodwa lolo lwazi lubaluleke kakhulu kudokotela ukuze aqale ukwelashwa ngokushesha. Ukukhula kwamagciwane kuyindlela kuphela yokubona ngokunembile amagciwane.

Yiziphi izifo ezingasiza ekuxilongweni yi-Gram stain test?

Odokotela bayala ukuhlolwa kwe-Gram stain ukusiza ekuxilongeni nasekuphatheni izifo ezithile zamagciwane. Isibonelo, isetshenziselwa ukuxilonga izimo ezifana nokutheleleka kwe-urinary tract (UTIs) kanye ne-bacterial pneumonia. Kodwa-ke, ayi-odwa kuzo zonke izifo zamagciwane. Isibonelo, i-Gram stain ayivame ukwenziwa ngento efana nokudla okunobuthi, kodwa ingenziwa kusampula yendle uma kudingeka.

Amabhaktheriya avamile e-Gram-negative kanye nezifo ezibangelwa yiwo

Nazi ezinye ze-Gram-negative bacteria kanye nezifo ezingabangelwa yizo:

• I- Escherichia coli : Ukutheleleka komgudu womchamo (UTIs), ubuthi bokudla.
• ` I-Legionella pneumoniae : Isifo se-Legionnaires.`
• I- Salmonella : Ubuthi bokudla, umkhuhlane we-typhoid.
• ` Klebsiella : I-pneumonia, izifo zegazi, izifo zamanxeba noma izindawo zokuhlinzwa, i-bacterial meningitis.`
• ` I-Neisseria gonorrhoeae : I-Gonorrhea.`
• ` I-Proteus : Ukutheleleka komgudu womchamo (ama-UTI).`
• ` Morganella morganii : Ukutheleleka komgudu womchamo (i-UTIs), i-sepsis, i-pneumonia, ukutheleleka kwamanxeba, ukutheleleka kwemisipha, ukutheleleka kwesistimu yezinzwa ephakathi, kanye ne-pericarditis (ukuvuvukala kolwelwesi oluzungeze inhliziyo).`
• I- Aeromonas : ukutheleleka kwamehlo, i-osteomyelitis (ukutheleleka kwamathambo), i-bacterial meningitis, ukutheleleka kokuphefumula "okusondela ekuminzeni", ukutheleleka kwamalunga.

Amabhaktheriya ajwayelekile e-Gram-positive kanye nezifo ezibangelwa yiwo

Nazi ezinye zezifo ezibangelwa yi-Gram-positive bacteria kanye nezifo ezingabangelwa yizo:

• ` I-Streptococcus pneumoniae : I-pneumonia ebangelwa yibhaktheriya.`
• I- Staphylococcus aureus : I-pneumonia yamagciwane, i-Staphylococcus aureus (MRSA) engamelana ne-methicillin, kanye ne-toxic shock syndrome.
• ` Iqembu A Uhlobo lwe-Streptococcus : Ukutheleleka kwe-Strep emphinjeni.`
• ` I-Listeria : Ubuthi bokudla.`
• ` I-Clostridium : Ubuthi bokudla.`
• 'I-Clostridium botulinum kanye ne-Clostridium butyricum: I-Botulism.

Ukuhlolwa kweGram kwenziwa nini?

Uma udokotela wakho esola ukuthi unesifo samagciwane, ngezinye izikhathi isifo sefungal, ngokuvamile uzofuna i-Gram stain kanye ne-bacterial culture. Lena indlela evamile yokubona ngokushesha isifo samagciwane emzimbeni wakho.

Ubani owenza ukuhlolwa kwe-Gram Stain?

Kuye ngohlobo lokutheleleka ongase ube nalo, izinhlobo ezahlukene zabahlinzeki bezempilo zingase ziqoqe isampula ukuze kuhlolwe i-Gram stain. Isibonelo, udokotela wezifo zabesifazane angase athathe i-swab ukuze kuhlolwe i-Gram stain ye-gonorrhea. Udokotela wezifo zamaphaphu angase athathe isampula ye-phlegm ekukhwehleleni noma esikhumbeni sakho bese eyithumela ukuze kuhlolwe i-Gram stain ye-pneumonia yamagciwane.

Udokotela wakho uzobe esebeka isampula esitsheni esingenamagciwane bese esithumela elabhorethri ukuze sihlolwe. Usosayensi welabhorethri yezokwelapha uzogcoba isampula kuma-slides e-microscope, afake uchungechunge lwedayi, bese eyibheka ngaphansi kwe-microscope. Bazobhala umbiko bese bewunika udokotela wakho.

Ulungiselela kanjani ukuhlolwa kwe-Gram Stain?

Izindaba ezinhle! Awudingi ukwenza lutho olukhethekile ukuze ulungiselele ukuhlolwa kwe-Gram stain.

Ukuhlolwa kwe-Gram Stain kwenziwa kanjani?

Ngokuvamile kunezinyathelo ezintathu eziyinhloko ekuhlolweni kwe-Gram stain:

• Ukuqoqa isampula.
• Ukulungiselela isampula.
• Ukuhlola isampula.

Ukuqoqa isampula yebala le-Gram

Lokhu kuhilela ukuthatha isampula endaweni lapho udokotela wakho esola khona ukuthi kukhona ukutheleleka. Nazi ezinye izindlela zokuthatha isampula enjalo:

• Ukuklwebha noma ukuxubha izicubu ebusweni bengxenye yomzimba wakho.
• Ukuqoqa uketshezi noma ukuphuma emzimbeni wakho.
• Ukufuthwa kwenaliti encane ukususwa kwesampula yoketshezi endaweni ethile emzimbeni wakho usebenzisa inaliti encane.

Nazi izindawo lapho ungathatha khona i-swab noma uxubhe isampula:

• Umphimbo
• Amakhala
• Izitho zangasese
• Izilonda zesikhumba

Amasampula ongawaqoqa ngqo esitsheni esingenamagciwane yile:

• Amathe (isikhwehlela)
• Umchamo
• Isihlalo

Izindawo zomzimba lapho kungadingeka khona ukufuthwa ngenaliti encane zifaka:

• Uketshezi lwe-synovial emalungeni akho.
• Uketshezi oluzungeze inhliziyo yakho (uketshezi lwe-pericardial).
• Uketshezi lwe-Pleural luwuketshezi oluzungeze amaphaphu akho.
• Uketshezi lwe-cerebrospinal (CSF) uketshezi oluzungeze umgogodla wakho.

Udokotela ube esebeka isampula esitsheni esingenamagciwane bese esithumela elabhorethri.

Indlela yokwenza i-Gram staining

Elabhorethri, usosayensi welabhorethri yezokwelapha usakaza isampula kumaslayidi e-microscope engilazi. Lawa maslayidi abizwa ngokuthi "ama-smear." Bese befaka uchungechunge lwamadayi ku-smear bese benza i-Gram stain.

Inqubo yokufaka umbala nge-Gram ihilela izinyathelo ezine eziyisisekelo:

• Ukusetshenziswa kombala oyinhloko (i-crystal violet).
• Ukwengeza isilungisi sombala (i-iodine kaGram).
• Ukushintsha umbala ngokushesha nge-ethanol, i-acetone, noma ingxube yakho kokubili.
• Ukwelapha nge-safranin.

Ukuhlola ibala le-Gram

Bese kuthi lapho usosayensi welabhorethri yezokwelapha eyibheka ngaphansi kwesibonakhulu, ahlunge noma yimaphi amabhaktheriya angaba lapho ngombala wawo kanye nesimo sawo :

• Umbala : Amabhaktheriya ane-Gram avame ukubonakala ephuzi kuya koluhlaza okwesibhakabhaka, kanti amabhaktheriya ane-Gram abonakala epinki kuya kobomvu.
• Isimo : Izimo ezivame kakhulu ziyindilinga (cocci) noma ezimise okwenduku (bacilli).

Futhi, usosayensi welabhorethri yezokwelapha ubheka amaqembu amabhaktheriya kuslayidi bese ebheka ezinye izici zesampula. Isibonelo:

• Ingabe ama-cocci akhona ngawodwa, ngamabili, ngamaqembu amane, ngamaqoqo, noma ngamaketanga?
• Ingabe ama-bacilli akhuluphele, mancane, mafushane, made, noma anama-spores amakhulu ngakolunye uhlangothi?
• Ingabe akhona amabhaktheriya ngaphakathi kwamaseli amhlophe egazi?

Usosayensi welabhorethri yezokwelapha uzobe eselungiselela umbiko bese ewuthumela kudokotela wakho.

Yiziphi izingozi zokuhlolwa kwe-Gram stain?

Akukho bungozi bokuthatha isampula ye-swab, noma ukunikeza isampula yamathe, umchamo, noma indle.

Ngokuphathelene nokuhlolwa kwegazi, izingozi ziphansi kakhulu. Kungase kube nobuhlungu kanye nokuklwebheka lapho igazi likhishwe khona, kodwa kuzophola ngokushesha.

Izingozi ezingaba khona zokufuthwa ngenaliti encane yilezi:

• Ukuzwa ubuhlungu noma ukungakhululeki.
• Ukopha.
• Ukutheleleka.
• Ukulimala kwezicubu ezizungezile.

Isho ukuthini imiphumela ye-Gram stain?

Imiphumela yokuhlolwa kwe-Gram stain iveza izinto ezimbili eziyinhloko: "i-Gram stain engemihle" noma "i-Gram stain enhle". Lokhu akufanele kudidaniswe negama elithi "gram-negative" noma "gram-positive" bacteria.

Ibala elibi le-Gram

Uma umphumela wakho wokuhlolwa uthi "i-Gram stain negative" noma "akukho okuphilayo okubonwe," ngokuvamile kusho ukuthi awekho amagciwane anele okubonwa yi-Gram stain. Kodwa-ke, uma wenza i-culture yesampula efanayo, usengathola amagciwane.

Ibala le-Gram elihle

Uma umphumela wakho wokuhlolwa uthi "positive Gram stain", kusho ukuthi kwakukhona amagciwane kusampula yakho. Uma umphumela wakho ubonisa ukuthi une-positive, ngokuvamile uzofaka ulwazi olufana nalolu:

• Uhlobo lwebhaktheriya : I-Gram-positive noma i-Gram-negative.
• Ukuma kwamagciwane : kungakhathaliseki ukuthi ayindilinga (i-cocci) noma ayisimo senduku (i-bacilli).
• Ezinye izici zamagciwane : ubukhulu bamabhaktheriya, ubuningi bawo (inani), kanye/noma indlela amabhaktheriya ahlanganiswe ngayo ndawonye, ​​uma kusebenza.
• Amanye amaseli : Kungakhathaliseki ukuthi kukhona amabhaktheriya ngaphakathi kwamanye amaseli (ngaphakathi kweseli), amaseli abomvu egazi, noma amaseli amhlophe egazi.
• Isikhunta : Ukuhlolwa kwe-Gram stain kungabheka nesikhunta ngesimo semvubelo noma isikhunta. Kodwa-ke, kudingeka ukuhlolwa okwengeziwe ukuze kutholakale ukuthi hlobo luni lwesikhunta.

Lolu lwazi, luhlanganiswe nezimpawu zakho kanye neminye imiphumela yezokwelapha, lungasiza udokotela wakho ukuthi anqume ukuthi yikuphi ukwelashwa okusebenza kahle kakhulu. Ngezinye izikhathi, lokhu kungaba usizo ngaphambi kokuba kutholakale imiphumela yokukhula kwamagciwane.

Kuthatha isikhathi esingakanani ukwazi imiphumela yokuhlolwa?

Ukuhlolwa kwe-Gram stain kuvame ukunikeza imiphumela esheshayo. Kodwa-ke, imiphumela ye-Gram stain ivame ukubhekwa njengeyokuqala . Lokhu kusho ukuthi yona yodwa ayikwazi njalo ukwenza ukuxilongwa. Kungadingeka ukuhlolwa kwamagciwane kanye/noma okunye (isibonelo, ukuhlolwa kwe-antigen kanye ne-antibody kwezinhlobo ezithile zamagciwane) ukuqinisekisa ukuxilongwa.

Kufanele ngishayele nini udokotela wami ucingo?

Uma kutholakale ukuthi unesifo futhi unezinkinga ngokwelashwa okutholayo, noma uma isifo sakho singabi ngcono, qiniseka ukuthi uthintana nodokotela wakho.

I-Gram stain iyisivivinyo esivame kakhulu, esivame ukungabi buhlungu, esisetshenziselwa ukuhlola ukutheleleka ngamagciwane noma isikhunta. Ukulinda imiphumela yokuhlolwa kokuxilonga kungaba nzima kakhulu. Kodwa khumbula, kungakhathaliseki ukuthi imiphumela ithini, ithimba lakho lezokwelapha likhona ukukusiza. Ungesabi ukubuza imibuzo mayelana nokuhlolwa kwakho noma imiphumela.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke kusukela kulokho esikuxoxile, ngithemba ukuthi unombono omuhle mayelana nokuhlolwa kwe-Gram Stain. Izinto eziyinhloko okufanele uzikhumbule yilezi:

• I-Gram stain iwukuhlolwa okunquma ngokushesha ukuthi akhona yini amabhaktheriya nokuthi aluhlobo luni .
• Lokhu kuhlukanisa amabhaktheriya njenge -gram-positive noma i-gram-negative . Kusiza udokotela ukuthi akhethe imithi.
• Nakuba imiphumela ishesha, ngezinye izikhathi iba ngeyokuqala . Kungadingeka ukukhuliswa kwamagciwane ukuze kutholakale amagciwane aqondile.
• Akukho bungozi obukhulu kulokhu kuhlolwa.
• Uma unemibuzo, ungesabi ukubuza udokotela wakho .

Ngakho-ke, uma udokotela ekucela ukuthi wenze ukuhlolwa okufana nalokhu, into ebaluleke kakhulu ukungesabi ngakho, kodwa ukuqonda ukuthi lokhu kuyinto ebalulekile enhlalakahleni yakho.

I- Gram stain, i-Gram stain, amagciwane, izifo, i-Gram positive, i-Gram negative, ukuhlolwa kwelebhu